Reduced Hip Adduction Is Associated With Improved Function After Movement-Pattern Training in Young People With Chronic Hip Joint Pain

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STUDY DESIGN:Ancillary analysis, time-controlled randomized clinical trial.BACKGROUND:Movement-pattern training (MPT) has been shown to improve function among patients with chronic hip joint pain (CHJP).OBJECTIVE:To determine the association among treatment outcomes and mechanical factors associated with CHJP.METHODS:Twenty-eight patients with CHJP, 18 to 40 years of age, participated in MPT, either immediately after assessment or after a wait-list period. Movement-pattern training included task-specific training to reduce hip adduction motion during functional tasks and hip muscle strengthening. Hip-specific function was assessed using the Modified Harris Hip Score (MHHS) and Hip disability and Osteoarthritis Outcome Score (HOOS). Three-dimensional kinematic data were used to quantify hip adduction motion, dynamometry to quantify abductor strength, and magnetic resonance imaging to measure femoral head sphericity using the alpha angle. Paired t tests assessed change from pretreatment to posttreatment. Spearman correlations assessed associations.RESULTS:There was significant improvement in MHHS and HOOS scores (P≤.02), adduction motion (P = .045), and abductor strength (P = .01) from pretreatment to posttreatment. Reduction in hip adduction motion (r = -0.67, P<.01) and lower body mass index (r = -0.38, P = .049) correlated with MHHS improvement. Alpha angle and abductor strength change were not correlated with change in MHHS or HOOS scores.CONCLUSION:After MPT, patients reported improvements in pain and function that were associated with their ability to reduce hip adduction motion during functional tasks.LEVEL OF EVIDENCE:Therapy, level 2b.

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